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All Journal Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Prosiding Seminar Kesehatan Masyarakat
Sudirman Sudirman
Faculty of Public Health, Universitas Muhammadiyah Palu, Indonesia
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Cadre Disposition as a Key Determinant of Local-Food Supplementary Feeding: A Mixed-Methods Study Sudirman Sudirman; Budiman Budiman; Sriyani Oktavia
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 1 (2026)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i2.8658

Abstract

Introduction: Stunting remains a major public health concern in Indonesia. Local-food supplementary feeding (PMT berbasis pangan lokal) is prioritized in national strategies, yet implementation fidelity varies. This study aimed to assess determinants of PMT implementation in Donggala, Indonesia, a sequential explanatory mixed-methods approach among community health cadres and health workers, guided by Edwards III’s policy implementation framework. Methodology: A sequential explanatory mixed-methods design was employedmixed-methods sequential explanatory design was applied. Quantitative data were collected via structured questionnaires from 54 cadres and health workers, while qualitative insights were derived from focus group discussions (FGDs). . Binary logistic regression examined the associations between communication, resources, disposition, and bureaucratic structure with PMT implementation, adjusting for education, occupation, and years of service. Results are presented as odds ratios (ORs), 95% confidence intervals (CIs), pseudo-R², and exact p-values. Qualitative data were derived from focus group discussions and analyzed thematically to contextualize quantitative findings. Results: Disposition emerged as the only statistically significant determinant in the adjusted model (OR = 21.01; 95% CI: 3.02–146.18; p = 0.002), whereas communication, resources, and bureaucratic structure lost significance after adjustment. Qualitative findings reinforced these results, highlighting intrinsic motivation, peer solidarity, and willingness to serve as key drivers of implementation. Participants also identified systemic barriers, including unclear SOP dissemination, limited resources, and administrative burdens, which affected program continuity and cadre performance. Conclusion: Cadre disposition plays a pivotal role in PMT implementation; however, its effectiveness depends on supportive structural and resource conditions. Motivation alone cannot compensate for weak communication systems, limited budgets, or burdensome administrative procedures. Strengthening supervision, improving communication channels, and ensuring adequate resource allocation are essential. Findings should be interpreted cautiously given the modest sample size and non-validated measurement instruments. Further research using larger samples and validated tools is recommended.
Medication Adherence and Therapeutic Success in Type 2 Diabetes Mellitus: A Narrative Review Annisa Juliarsih; Sudirman Sudirman; Ahmad Yani
PROSIDING SEMINAR KESEHATAN MASYARAKAT Vol 4 No Juli (2026): Proceeding of The 3rd International Seminar on Public Health and Sports (ISOPH
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Semarang

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Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring long-term pharmacological treatment and sustained self-management. Medication adherence is a critical determinant of glycemic control and therapeutic outcomes; however, suboptimal adherence remains a persistent challenge in outpatient diabetes care.. Method: This narrative review synthesized open-access evidence published predominantly between 2021 and 2026. Literature was identified through PubMed/MEDLINE, ScienceDirect, SpringerLink, Wiley Online Library, DOAJ, and Google Scholar, supplemented by reports from the World Health Organization, International Diabetes Federation, Indonesian Ministry of Health, and BPJS Kesehatan. The synthesis focused on evidence regarding medication adherence among outpatients with T2DM, determinants of non-adherence, and its implications for HbA1c, glycemic control, quality of life, and therapeutic outcomes. Results: The reviewed evidence indicates that adherence to antidiabetic medications remains suboptimal and is generally associated with poorer glycemic control. Non-adherence is influenced by multidimensional factors, including inadequate knowledge, medication beliefs, low self-efficacy, depressive symptoms, regimen complexity, polypharmacy, adverse effects, comorbidities, treatment costs, limited family support, medication accessibility, and healthcare-provider communication. Patient-centered interventions, particularly pharmacist-led counseling, regimen simplification, family engagement, and structured chronic disease management, demonstrate potential to improve adherence and clinical outcomes. Conclusion: Medication adherence should be routinely assessed as an integral component of T2DM management before treatment intensification. Multilevel, patient-centered, and health-system-supported interventions are required to address modifiable barriers and improve adherence, glycemic control, quality of life, and therapeutic outcomes
Co-Authors Ahmad Yani Annisa Juliarsih Budiman Budiman Sriyani Oktavia